Is systolic blood pressure high in patients with acute aortic dissection on first medical contact before hospital transfer?

Akutsu, Koichi; Yoshino, Hideaki; Shimokawa, Tomoki; Ogino, Hitoshi; Kunihara, Takashi; Takahashi, Toshiyuki; Usui, Michio; Watanabe, Kazuhiro; Tobaru, Tetsuya; Hagiya, Kenichi; Shimizu, Wataru; Niino, Tetsuya; Kawata, Mitsuhiro; Masuhara, Hiroshi; Watanabe, Yozo; Yoshida, Nobuko; Yamamoto, Takeshi; Nagao, Ken; Takayama, Morimasa

doi:10.1007/s00380-019-01419-9

Cited by 10 publications

(5 citation statements)

References 15 publications

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“…SBP in type A AD in the acute period is affected by many factors that lower it, such as cardiac tamponade, aortic rupture, or dissection extending to the brachiocephalic artery and/or subclavian artery. 13) The present study also showed that higher SBP just before admission was observed more frequently in patients with type B than in those with type A AD. Some retrospective studies have been reported past history of hypertension was more prevalent in type B than type A.…”

Section: Hypertension and Adsupporting

confidence: 79%

“…Higher SBP on admission has been observed more frequently in patients with type B than in those with type A AD. 2 , 11 , 13) However, the differences in SBP on admission do not necessarily mean the different prevalence of preexisting hypertension, even if they measured SBP in very early after the symptom onset. SBP in type A AD in the acute period is affected by many factors that lower it, such as cardiac tamponade, aortic rupture, or dissection extending to the brachiocephalic artery and/or subclavian artery.…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, hypertension was reported in 44-86% of patients with AD 1,2,[11][12][13][14][15][16] and was considered one of the representative causes of AD. High SBP on admission 2,11,13,14) and a past history of hypertension 1,2,12,[14][15][16] are frequently observed in patients with AD. Higher SBP on admission has been observed more frequently in patients with type B than in those with type A AD.…”

Section: Hypertension and Admentioning

confidence: 99%

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Left Ventricular Hypertrophy Is More Prevalent in Type B than Type A Aortic Dissection

Akutsu

Ozaki

Oshima

et al. 2021

ATCS

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Objectives: Several factors determining differences between types A and B aortic dissection (AD) have been reported; however, little data exist examining their differences in left ventricular hypertrophy (LVH). We compared the prevalence of LVH in patients with types A and B AD. Methods: We retrospectively analyzed 334 patients with acute AD (227 type A; 107 type B). Concentric hypertrophy (CH; increased left ventricular mass index [LVMI] and relative wall thickness [RWT]) is one of four types of left ventricular (LV) geometry thought to be most associated with hypertension. We compared LVMI and the prevalence of CH in patients with types A or B AD. Multivariate logistic regression analyses of variables associated with type B AD were performed. Results: Comparing type A and B AD, LVMI (95 ± 26 vs.107 ± 28, p <0.001) and prevalence of CH (26% vs. 44%, p = 0.001) were higher in type B AD. In multivariate analysis, CH was an independent factor associated with type B AD (odds ratio: 2.62, confidence interval: 1.54–4.47, p <0.001). Conclusions: Our data suggested LVH was more prevalent in type B than in type A AD. Considering LVH usually results from hypertension, patients with type B AD may be more affected by hypertension than those with type A.

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Section: Hypertension and Adsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Hypertension and Admentioning

confidence: 99%

See 1 more Smart Citation

Left Ventricular Hypertrophy Is More Prevalent in Type B than Type A Aortic Dissection

Akutsu

Ozaki

Oshima

et al. 2021

ATCS

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“…The Tokyo Cardiovascular Care Unit (CCU) Network is an emergent transfer system for patients with all types of cardiovascular diseases that covers the entire Tokyo metropolitan region except the island areas. 10 , 11 As reported previously, 12 , 13 , 14 , 15 we inaugurated the Tokyo Acute Aortic Super-network in November 2010, established based on the Tokyo CCU Network, to develop an effective and safe transfer system for patients with AAD and ruptured aortic aneurysm using ambulance units through the control room of the Tokyo Fire Department. Detailed data of all patients treated in their emergency departments, cardiovascular surgery departments, and CCUs are routinely recorded and submitted to the data management center on specific survey forms.…”

Section: Methodsmentioning

confidence: 82%

Sex Differences in DeBakey Type I/II Acute Aortic Dissection Outcomes

Takahashi,

Yoshino,

Shimokawa

et al. 2023

JACC: Advances

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“…The Tokyo Acute Aortic Super‐Network currently consists of 39 participating hospitals with specialized care for AAD and ruptured aortic aneurysm; patients with suspected or confirmed AAD are first referred to such hospitals, as reported elsewhere. 20 , 21 Detailed data on all patients treated in their emergency departments, cardiovascular surgery departments, and cardiovascular care units were routinely recorded and submitted to the data management center on specific survey forms.…”

Section: Methodsmentioning

confidence: 99%

Sex‐Related Differences in Clinical Features and In‐Hospital Outcomes of Type B Acute Aortic Dissection: A Registry Study

Takahashi

Yoshino

Akutsu

et al. 2022

JAHA

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Background The association between female sex and poor outcomes following surgery for type A acute aortic dissection has been reported; however, sex‐related differences in clinical features and in‐hospital outcomes of type B acute aortic dissection, including classic aortic dissection and intramural hematoma, remain to be elucidated. Methods and Results We studied 2372 patients with type B acute aortic dissection who were enrolled in the Tokyo Acute Aortic Super‐Network Registry. There were fewer and older women than men (median age [interquartile range]: 76 years [66–84 years], n=695 versus 68 years [57–77 years], n=1677; P <0.001). Women presented to the aortic centers later than men. Women had a higher proportion of intramural hematoma (63.7% versus 53.7%, P <0.001), were medically managed more frequently (90.9% versus 86.3%, P =0.002), and had less end‐organ malperfusion (2.4% versus 5.7%, P <0.001) and higher in‐hospital mortality (5.3% versus 2.7%, P =0.002) than men. In multivariable analysis, age (per year, odds ratio [OR], 1.06 [95% CI, 1.03–1.08]; P <0.001), hyperlipidemia (OR, 2.09 [95% CI, 1.13–3.88]; P =0.019), painlessness (OR, 2.59 [95% CI, 1.14–5.89]; P =0.023), shock/hypotension (OR, 2.93 [95% CI, 1.21–7.11]; P =0.017), non–intramural hematoma (OR, 2.31 [95% CI, 1.32–4.05]; P =0.004), aortic rupture (OR, 26.6 [95% CI, 14.1–50.0]; P <0.001), and end‐organ malperfusion (OR, 4.61 [95% CI, 2.11–10.1]; P <0.001) were associated with higher in‐hospital mortality, but was not female sex (OR, 1.67 [95% CI, 0.96–2.91]; P =0.072). Conclusions Women affected with type B acute aortic dissection were older and had more intramural hematoma, a lower incidence of end‐organ malperfusion, and higher in‐hospital mortality than men. However, female sex was not associated with in‐hospital mortality after multivariable adjustment.

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Is systolic blood pressure high in patients with acute aortic dissection on first medical contact before hospital transfer?

Cited by 10 publications

References 15 publications

Left Ventricular Hypertrophy Is More Prevalent in Type B than Type A Aortic Dissection

Left Ventricular Hypertrophy Is More Prevalent in Type B than Type A Aortic Dissection

Sex Differences in DeBakey Type I/II Acute Aortic Dissection Outcomes

Sex‐Related Differences in Clinical Features and In‐Hospital Outcomes of Type B Acute Aortic Dissection: A Registry Study

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